Paralyzed Actor Regains Some Feeling in His Upper Chest

By LAWRENCE K. ALTMAN

Published: June 3, 1995

Correction Appended

Christopher Reeve, the actor who became quadriplegic when he was thrown headfirst from a horse last Saturday, has regained some feeling in his upper chest but there is no change in the paralysis extending from his neck down, his doctor said yesterday.

The return of some sensation is an encouraging sign that Mr. Reeve did not sever his spinal cord and might regain an undetermined amount of function. Nevertheless, the injury remains devastating, said Dr. John A. Jane, Mr. Reeve's neurosurgeon.

Doctors caring for Mr. Reeve, 42, at the University of Virginia Medical Center in Charlottesville, detected the change in sensation beginning Wednesday night, and the return of feeling may be continuing, Dr. Jane said in an interview.

"He definitely feels" in the upper chest, and "seems fully alert," Dr. Jane said of Mr. Reeve, who starred as Superman in several movies and recently played a wheelchair-bound detective in a cable television movie.

Mr. Reeve can breathe only with the aid of a respirator and communicates with his doctors, nurses and family by mouthing words.

"He cannot control his expiration, so what he has to do is to say words in an exaggerated fashion and use local breaths to make a sound, and it doesn't work badly," said Dr. Jane "It's not good enough for back and forth rapid conversation, but it's good enough to communicate."

Mr. Reeve "is lucid," said his brother, Benjamin, at a press conference, and "has his sense of humor." Family members have read Mr. Reeve many of the letters sent to him.

Infection is one of the major complications of spinal cord injuries, and Mr. Reeve has pneumonia in one lung but it is improving. "Pneumonias come and go in these kind of cases, and it is going now, but I am sure it will come back," Dr. Jane said.

Mr. Reeve will probably undergo surgery on Monday to fuse the top two vertebrae in his neck.

By giving greater stability to Mr. Reeve's neck, the doctors hope to prevent jagged bone fragments from cutting nerves and further damaging the spinal cord. The vertebrae, known as C-1 and C-2, were shattered in the horse accident. Dr. Jane said the spinal cord "definitely has not been totally severed at C-1" as he had initially feared.

The spinal cord carries nerve impulses between the brain and the rest of the body. The nerves control various sensations and the ability to make muscles contract. In Mr. Reeve's case there has been no return of motor function.

There may have been ongoing improvement in Mr. Reeve's feeling since Wednesday night. There are hints that "sensation is spreading down his upper arm as well, and that is my reason for saying that I know the cord is not severed," said Dr. Jane.

The operation, which takes two to five hours, carries the risk of worsening Mr. Reeve's condition and has a 1 to 3 percent risk of death, mainly from stress and effects on the cardiovascular system, Dr. Jane said.

The ligaments that usually help hold bone in place are so heavily damaged that Dr. Jane said he doubted the vertebrae will fuse naturally.

The main damage to Mr. Reeve's spinal cord is at a level between the first and second cervical vertebrae. The sensory changes are "definitely below that level, so he has got to have some fibers going through," he said.

Dr. Jane, who heads the department of neurosurgery at the University of Virginia, said he had seen similar responses in some other spinal cord injuries and that it was "too early to say what is going to happen" in Mr. Reeve's case.

An unidentified anesthesiologist happened to be at Commonwealth Park, where Mr. Reeve's accident occurred in Culpeper, Va., and started mouth-to-mouth resuscitation, Dr. Jane said. Mr. Reeve may have been unconscious for an undetermined period before his admission to University of Virginia Medical Center. But he has been conscious since then and there is no indication at this point that Mr. Reeve has suffered brain damage in addition to his spinal cord injury, Dr. Jane said.

In recent years, researchers have shown that injections of steroids within a few hours of a spinal cord injury can reduce the severity of damage in some cases. Mr. Reeve was given steroids immediately after he arrived in an emergency room, Dr. Jane said.

"He's very eager to get up," Dr. Jane said.

But he said that decisions about where Mr. Reeve might undergo rehabilitation are "too far in the future."

Most people who suffer spinal cord injuries of the type Mr. Reeve experienced die before they get to a hospital, and the death rate is high even for those who do receive medical care. Dr. Jane cited one study published about 20 years ago in which four of seven patients whose spinal cord had been severed high in the neck died. However, care of spinal cord injuries has improved since then.

Photo: A doctor said yesterday that the actor Christopher Reeve wouldprobably undergo surgery on Monday. The "Superman" star got advice last Saturday from Grant Schneidman of the United States Equestrian team just before the accident in Culpeper, Va. (Associated Press)